Cultures of Harm in Institutions of Care: Historical and Contemporary Perspectives

In 1921, Dr Montagu Lomax published a searing indictment of Prestwich Asylum exposing an entrenched sub-culture of malpractice, negligence and abuse. Recent historical research has shown that many of the same practices were still taking place at Prestwich fifty years later.[i]

Today, most institutions provide the best possible standards of care. But abuse can still happen. Stafford Hospital, Winterbourne View and the crimes committed by Jimmy Savile are among the more recent examples of how systemic violence and neglect can be visited upon some of society’s most vulnerable individuals in institutions that have been charged with a special duty of care.

This two-day conference will explore the shifting political, socio-economic, cultural and medical influences that have formed and perpetuated cultures of harm from the eighteenth century to the present day around the world. We are particularly interested in the production of harmful practices – physical, sexual and psychological violence directed by one person or group against another – in therapeutic and caring environments. These might include hospitals and infirmaries, psychiatric facilities, religious institutions, care homes, children’s homes and educational establishments, as well as infirmaries and medical spaces in prisons and correctional institutions, military barracks, camps and workhouses.

Themes include:

• Institutional contexts that contribute to specific cultures and social relationships between individuals and groups
• The impact of wider societal factors on institutional cultures and contexts
• The impact of wider political and commercial factors, such as cuts to funding and ‘market forces’, on institutional cultures and practices
• Shifting power relations and cultural differences and similarities between staff, patients and other groups
• Issues around individual and collective agency, resistance and complicity, as well as coercion, scapegoating, ‘whistleblowing’, bullying and negotiation between individuals
• The role and use of space such as seclusion, locked wards, single/mixed-sex wards
• Effects of the institutional environment such as lack of stimulation, lack of privacy, poor communication, and a failure to support staff
• Treatments, medication, the use of restraints, issues around consent
• Staff recruitment, conditions and training
• The role of emotions such as fear, pain, shame, humiliation, guilt, anger, sadness, pleasure, desire and nostalgia
• The role of narrative, language and silence, reporting and non-reporting, including the use of the language of care and therapy to justify violent practice
• Representations in literature, drama, film and art
• Factors that have disrupted or changed harmful cultures for the better
• The role of wider public institutions and agencies such as medicine, the law, social services, academia, religion, government and the media
• Theoretical, methodological and ethical approaches and challenges.

Confirmed keynote speakers: Allan Young, an anthropologist and the Marjorie Bronfman Professor in Social Studies in Medicine (McGill); and Richard Bessel, Professor of Twentieth Century History (York).

This event is organised by Professor Joanna Bourke, Dr Louise Hide and Dr Ana Antic in association with the Birkbeck Trauma Project at the Department of History, Classics and Archaeology

[i] John Hopton, ‘Prestwich Hospital in the twentieth century: a case study of slow and uneven progress in the development of psychiatric care’, History of Psychiatry, x (1999), 349-69.